<div id="alias-new">

<form action="dataops.php" method="post" name="forms1">

    <dl>

        <dt><label>First Name</label></dt>
        <dd><input type="text" name="first_name" tabindex="1" /></dd>
        
        <dt><label>Middle Name</label></dt>
        <dd><input type="text" name="middle_name" tabindex="1" /></dd>
        
        <dt><label>Last | Org. Name</label></dt>
        <dd><input type="text" name="last_name" tabindex="1" /></dd>
        
        <dt><label>Jr., Sr., etc.</label></dt>
        <dd><input type="text" name="extra_name" tabindex="1" /></dd>
        
        <dt><label>SSN</label></dt>
        <dd><input type="text" name="ssn" tabindex="1" /></dd>
        
        <input type="hidden" name=action value="new_alias" />
        <input type="hidden" name="contact_id" value="%%[contact_id]%%" />

        <dd>
        <ul><li><input type="submit" value="Continue" tabindex="1" /></li></ul>
        </dd>

    </dl>

<script language="javascript" type="text/javascript"><!--
document.forms1.first_name.focus();
//--></script>

</form>

</div> <!-- #alias-new -->